Sinha Arvind, Aithal Shrilakshmi
Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
J Indian Assoc Pediatr Surg. 2025 May-Jun;30(3):265-270. doi: 10.4103/jiaps.jiaps_247_24. Epub 2025 Mar 3.
Children with high-pressure bladders are at an increased risk of upper tract deterioration, potentially leading to chronic renal failure if not adequately managed. Regular bladder pressure monitoring is essential, especially in patients with neurogenic bladders, often resulting from spinal dysraphism. Urodynamic studies (UDSs) are the gold standard for assessing bladder pressure but are invasive, resource-intensive, and uncomfortable for patients. Over the last many decades, there have been regular attempts to characterize the morphology of the neurogenic bladder, including the classical subjective appearance of the "Christmas Tree" bladder, to objectively define the shape of the bladder via the use of height-to-width ratio. The study explores the evolution of scientific efforts to define bladder morphology in neurogenic bladder and to describe the current state of evidence regarding the correlation of the shape of the bladder with the detrusor pressures and upper tract changes in children with neurogenic bladder.
膀胱高压的儿童上尿路恶化风险增加,如果管理不当可能导致慢性肾衰竭。定期监测膀胱压力至关重要,尤其是对于神经源性膀胱患者,这类患者通常由脊柱裂引起。尿动力学研究(UDS)是评估膀胱压力的金标准,但具有侵入性、资源密集且让患者不适。在过去几十年里,人们一直在定期尝试描述神经源性膀胱的形态,包括经典的主观外观“圣诞树”膀胱,并通过使用高宽比来客观定义膀胱形状。本研究探讨了在神经源性膀胱中定义膀胱形态的科学努力的演变,并描述了目前关于神经源性膀胱患儿膀胱形状与逼尿肌压力及上尿路变化之间相关性的证据状况。